[226赫兹与1000赫兹鼓室导抗图在婴幼儿中耳积液诊断中的比较]
[A comparison of 226 Hz and 1 000 Hz tympanometry in diagnosis of infants otitis media effusion].
作者信息
Liu Hui, Mo Lingyan, Jing L V, Chen Jing, Ji Chen, Chen Xueqing, Liu Zhicheng
出版信息
Lin Chuang Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2014 May;28(10):701-4.
OBJECTIVE
To provide a clinical reference by comparing the conventional 226 Hz tympanometry with 1000 Hz tympanometry in two groups of young children with otitis media effusion evidenced by CT scan.
METHOD
One hundred and seventy-seven young children (226 ears), from 1 to 60 months, with otitis media effusion were involved in this study. They were divided into six groups by age: 0-6 months group, 6-12 months group, 12-18 months group, 18-24 months group, 24-36 months group, 36-60 months group. They were tested with tympanometry of 2 probe-tones of 226 and 1 000 Hz. Type A tympanogram was defined as a normal middle ear function in 226 Hz and single-or double-peak in 1 000 Hz tympanometry. One hundred and fifty-eight normal young children (266 ears) were selected as control group. The results were analysed with Chi square test. Receiver operator characteristic (ROC) analysis was performed to evaluate the two methods.
RESULT
In the young children with otitis media effusion, the detection rate of 226 Hz tympanogram in six groups was 21.1%, 35.2%, 46.9%, 42%, 62.5% and 68% respectively, while 94.7%, 98.1%, 96.9%, 91.2%, 95.8% and 88% respectively in 1 000 Hz tympanogram. In the young children with normal middle ear function, the detection rate of 226 Hz tympanogram in six groups was 95.1%, 88.6%, 85.1%, 93.3%, 88.5% and 93.5%, while 87.8%, 94.3%, 89.4%, 95.6%, 94.2% and 97.8% respectively in 1 000 Hz tympanogram. The detection rate was significantly different between 226 and 1 000 Hz tympanogram in the young children under 36-month old.
CONCLUSION
A single-or double-peak 1000 Hz tympanometric patterns as normal criteria was a simple way to evaluate young children s' middle ear function. 1 000 Hz tympanometry should be given priority to the children within 36-month old in detection middle ear function,the 226 and 1 000 Hz tympanometry should be done at the same time within 36-60 months old.
目的
通过比较传统的226Hz鼓室导抗图与1000Hz鼓室导抗图，为两组经CT扫描证实有中耳积液的幼儿提供临床参考。
方法
177名1至60个月患有中耳积液的幼儿（226耳）参与本研究。他们按年龄分为六组：0 - 6个月组、6 - 12个月组、12 - 18个月组、18 - 24个月组、24 - 36个月组、36 - 60个月组。对他们进行226Hz和1000Hz两种探测音的鼓室导抗测试。226Hz时A型鼓室导抗图定义为中耳功能正常，1000Hz鼓室导抗测试为单峰或双峰。选取158名正常幼儿（266耳）作为对照组。结果采用卡方检验进行分析。进行受试者操作特征（ROC）分析以评估这两种方法。
结果
在患有中耳积液的幼儿中，六组226Hz鼓室导抗图的检出率分别为21.1%、35.2%、46.9%、42%、62.5%和68%，而1000Hz鼓室导抗图分别为94.7%、98.1%、96.9%、91.2%、95.8%和88%。在中耳功能正常的幼儿中，六组226Hz鼓室导抗图的检出率分别为95.1%、88.6%、85.1%、93.3%、88.5%和93.5%，而1000Hz鼓室导抗图分别为87.8%、94.3%、89.4%、95.6%、94.2%和97.8%。36个月以下幼儿中226Hz和1000Hz鼓室导抗图的检出率有显著差异。
结论
以1000Hz鼓室导抗图单峰或双峰模式作为正常标准是评估幼儿中耳功能的一种简单方法。在检测36个月以下幼儿中耳功能时应优先采用1000Hz鼓室导抗测试，36 - 60个月时应同时进行226Hz和1000Hz鼓室导抗测试。
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